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Prevalence estimates of dementia in older adults in rural Kilimanjaro 2009–2010 and 2018–2019: is there evidence of changing prevalence?

Lookup NU author(s): Dr Stella Paddick, Dr Catherine Dotchin, Professor Dame Louise Robinson, Professor Richard Walker

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

© 2021 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons Ltd.Introduction: Although limited, existing epidemiological data on dementia in sub-Saharan Africa indicate that prevalence may be increasing; contrasting with recent decreases observed in high-income countries. We have previously reported the age-adjusted prevalence of dementia in rural Tanzania in 2009–2010 as 6.4% (95% confidence interval [CI] 4.9–7.9) in individuals aged ≥70 years. We aimed to repeat a community-based dementia prevalence study in the same setting to assess whether prevalence has changed. Methods: This was a two-phase door-to-door community-based cross-sectional survey in Kilimanjaro, Tanzania. In Phase I, trained primary health workers screened all consenting individuals aged ≥60 years from 12 villages using previously validated, locally developed, tools (IDEA cognitive screen and IDEA-Instrumental Activities of Daily Living questionnaire). Screening was conducted using a mobile digital application (app) on a hand-held tablet. In Phase II, a stratified sample of those identified in Phase I were clinically assessed using the DSM-5 criteria and diagnoses subsequently confirmed by consensus panel. Results: Of 3011 people who consented, 424 screened positive for probable dementia and 227 for possible dementia. During clinical assessment in Phase II, 105 individuals met DSM-5 dementia criteria. The age-adjusted prevalence of dementia was 4.6% (95% CI 2.9–6.4) in those aged ≥60 years and 8.9% (95% CI 6.1–11.8) in those aged ≥70 years. Prevalence rates increased significantly with age. Conclusions: The prevalence of dementia in this rural Tanzanian population appears to have increased since 2010, although not significantly. Dementia is likely to become a significant health burden in this population as demographic transition continues.


Publication metadata

Author(s): Yoseph M, Paddick S-M, Gray WK, Andrea D, Barber R, Colgan A, Dotchin C, Urasa S, Kisoli A, Kissima J, Haule I, Rogathi J, Safic S, Mushi D, Robinson L, Walker RW

Publication type: Article

Publication status: Published

Journal: International Journal of Geriatric Psychiatry

Year: 2021

Pages: epub ahead of print

Online publication date: 22/01/2021

Acceptance date: 27/12/2020

Date deposited: 08/04/2021

ISSN (print): 0885-6230

ISSN (electronic): 1099-1166

Publisher: John Wiley and Sons Ltd

URL: https://doi.org/10.1002/gps.5498

DOI: 10.1002/gps.5498

PubMed id: 33480089


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